A Study on the Evaluation of the Staphylococcal Exotoxins and Staphylococcal Enterotoxin A-specific IgE Antibody in Childhood Atopic Dermatitis / 대한피부과학회지

BACKGROUND: The skin of patients with atopic dermatitis (AD) exhibits a striking susceptibility to colonization with Staphylococcus aureus (S. aureus). Superantigenic exotoxins produced by S. aureus and their specific IgE antibodies are thought to be important precipitating factors of AD, but there are few reports evaluating these 2 factors at the same time. OBJECT: Our purpose was to examine whether the isolation of S. aureus colonies and the presence of the exotoxins from the skin of childhood AD patients and the level of anti-staphylococcal enterotoxin A(SEA) IgE antibody in their sera correlated with their severity of AD. METHODS: Thirty patients with mild-to-severe AD, 2 to 15 years of age, were evaluated by using SCORAD index. S. aureus was isolated from lesional and non-lesional skin of AD patients, and from healthy controls. By using reversed passive latex agglutination toxin detection kits, we examined whether staphylococcal exotoxins could be detected. Anti-SEA IgE antibody was determined by using AlaSTAT(R)assay. RESULTS: S. aureus colonizations were found in 11(36.7%) of the lesional skin and in 5(16.7%) of the non-lesional skin of 30 AD patients. Staphylococcal exotoxins were detected in 5(45.5%) of the 11 colonizations from lesional skin and in 2(40%) of the 5 colonizations from non-lesional skin. SEA was most frequently detected. S. aureus colonization was correlated with the severity of AD. However, there were no statistical significances between severity of AD and others such as exotoxin production, and the level of total IgE and anti-SEA IgE. Total IgE level was significantly higher in the group of exotoxin production, and correlated with the level of anti-SEA IgE. CONCLUSION: The correlation between S. aureus colonization and severity of AD in our study might support the role of S. aureus in patients with AD. On the other hand, it could be considered that exacerbation of AD trigger more colonization of S. aureus by way of disruption of skin barrier function from scratching or reduced immune responses needed for defense against bacteria. Although there was no correlation between AD severity and exotoxin production and the level of anti-SEA IgE in this study, staphylococcal exotoxins and their specific IgE antibodies might play a role at least in a subset of AD patients.

A Study of the Latex Allergy in Operating Room Nurses / 대한피부과학회지

BACKGROUND: Allergy to natural rubber latex has become an important occupational health concern in recent years, particularly among health care workers. Studies have estimated that the prevalence of latex allergy ranged from 2.8% up to 12.1% of health care workers. Latex sensitization is more common in operating rooms or with special care nurses whose jobs require frequent glove use. OBJECT: The present study was undertaken to assess the prevalence of latex sensitivity in operating room nurses, and to evaluate the relationship between questionnaire responses and skin tests. METHODS: Eighty operating room nurses working in the Hallym Medical Center and 27 healthy controls were included in this study. The questionnaire was completed by a dermatology doctor during an interview. Skin prick tests(SPT) were carried out on the volar surface of the forearm using latex glove extract solution, commercial latex extract and several commercial fruit extracts. If SPT was positive, use test was performed. Patch tests for delayed type hypersensitivity were carried out with small piece of latex glove(as is), commercial latex antigen and rubber additives. RESULTS: 1. Twenty two(27.5%) of 80 operating room nurses reported at least one symptom when wearing gloves. Although the symptom development was increased as glove-wearing time increased, but the difference was not statistically significant. The history of atopy and dental care did not influence the prevalence of symptoms. Subjects with hand eczema had significantly higher prevalence of symptoms than without hand eczema. 2. In SPT, 9(11.3%) of 80 operating room nurses were positive to latex glove extract solution. This level was significantly higher than healthy controls who showed positive reaction in only one. The history of hand eczema and dental care did not influence the prevalence of symptoms. Although the difference was not statistically significant, the symptom development was increased as glove-wearing time and years of experience increased. The percentage of skin reactions to latex was 2.6 times higher in nurses with atopy than without atopy, but the difference was not statistically significant. Reactions to fruit extracts including tomato, banana, mixed nut and potato were 5.0%, 3.8%, 2.5% and 1.3%, respectively. Use test was done with 7 of 9 showing positive reaction to SPT, and all of them showed positive responses. 3. Patch tests revealed positive results for latex gloves in 3 (3.8%), for commercial latex extract in 2 (2.5%) and for thiuram mix in 1 (1.3%) of 80 operating room nurses. But there were no positive results with ZnBDC, ZnEDC, TMTD, mercapto mix and mercaptobenzothiazole in nurses. For all allergens in patch test, any healthy subjects did not show positive results. CONCLUSION: Twenty two(27.5%) of 80 operating room nurses reported at least one symptom when wearing gloves. The most commonl compained symptom was itching, which was ceported in all of them. Localized wheal, generalized wheal and pain were reported in 8.8%, 5.0% and 2.5%, respectively. However, anaphylaxis was not reported. As the positive rate was 3.8% in patch test and 11.3% in SPT using latex glove extract, most of the symptoms related to the wearing of latex gloves appeared to be due to irritation. It could be considered that latex allergy could be induced by repeated wearing of latex gloves in operating room nurses.

A Comparative Study of Atopy Patch Test Using House Dust Mite Antigens with Skin Prick Test and Specific Serum IgE Level in Atopic Dermatitis / 대한피부과학회지

BACKGROUND: In some patients with atopic dermatitis (AD), eczematous skin lesions can be induced by atopy patch test (APT) with house dust mite antigen. The results of APT in patients with AD varies in different studies, probably because of different test techniques. OBJECT: This study was done to evaluate the differences in three different APT techniques, and the relationship between APT and skin prick test, total IgE, and specific serum IgE level. METHODS: We performed patch test in 93 patients with AD and 30 normal controls on clinically lesional and normal appearing skin with commercial house dust mite allergens in three different techniques (standard, scratch, DMSO). Reactions were evaluated after 48hours, and compared with the results of skin prick test, total and specific IgE levels. Detailed atopy history and severity scoring were taken. RESULTS: There were no significant differences in positive APT results with three different techniques and different areas (lesional and normal appearing skin). The APT results showed significant concordances with skin prick test and RAST for house dust mite antigens. But there were no statistical significances between APT results and severity score and total IgE level. CONCLUSION: The correlation of APT and RAST-skin prick test in this study suggests a possible role of delayed allergic reaction in the development of eczematous skin lesions after house dust mite antigen contact. The APT seems to be a valuable tool in diagnostic work-up in patients with atopic dermatitis.

A Case of Factitious Urticaria Strongly Responded to Cockroach Extracts / 대한피부과학회지

The impact of indoor allergens is greater than that of outdoor or occupational environments. Cockroaches have been demonstrated to be an etiologic factor in allergic diseases, especially in patients with lower socioeconomic classes in large urban areas. Infestations of cockroaches are largely dependent on housing conditions, and hypersensitivity is dependent on exposure. We herein report a 38-year-old man with factitious urticaria revealed strong positive reactions to crude extracts of American cockroach and German cockroach at a skin pinprick test and Western blot analysis.

A Case of Anhidrotic Ectodermal Dysplasia with Atopic Dermatitis / 대한피부과학회지

Anhidrotic ectodermal dysplasia(AED) is a rare hereditary disorder characterized by hypohidrosis or anhidrosis, hypotrichosis, dental hypoplasia and characteristic facies. Additional less consistent symptoms include nail dystrophy, hyperkeratosis of the palms and soles, cleft palate, hyperplasia of facial sebaceous glands, susceptibility to atopic dermatitis, dryness of mouth and eyes, and hypoplasia of mucous and mammary glands. In general, the inheritance of this syndrome is determined by an X-linked recessive gene, and several hundred cases, of which over 90% are male, have been reported in many differnt races. We experienced a case of AED associated with atopic dermatis.

Two Cases of Irritant Contact Dermatitis due to Garlic / 대한피부과학회지

Garlic(Allium sativum) has been used for centuries for culinary purposes in folk medicine as a medicinal agent for the treatment various disorders, including parasitic and fungal infections. Garlic, however, is responsible for allergic and irritant contact dermatitis in cooks and housewives. Recently we experienced two cases of irritant contact dermatitis after application of garlic used as a naturopathic remedy for the treatment of pruritus.

A Case of Dermatomyositis Associated with Stomach Cancer / 대한피부과학회지

Dermatomyositis is a rare disease of unknown origin characterized by symmetrical muscle weakness and specific skin lesions. A link between dermatomyositis and internal malignancy has long been suspected. A 76-year-old male patient presented with erythematous patches and crusted papules associated with muscle pain and weakness of upper extremity. As he showed characteristic clinical feature, and abnormal electromyogram and muscle biopsy finding, he could be diagnosed by dermatomyositis. Three months later, nevertheless appropriate treatment, pain and weakness of upper extremity were more aggravated. On the radiologic examination advanced gastric cancer with multiple metastases were found.

A Case of Congenital Trichofolliculoma / 대한피부과학회지

Trichofolliculoma is a benign, highly structured adenoma of the pilosebaceous unit, usually occuring on the face or scalp as 0.5 to 1.0 cm solitary papule in persons past middle age. This benign neoplasm rarely occurs prior to early adult life or neonate. We report a case of congenital trichofolliculoma in a 13-year-old girl who had had a single asymptomatic mass on the posterior aspect of right auricle since birth.

What Effects Dose Testicular Injury Have on Reproductive Function? / 대한비뇨기과학회지

No abstract available.

A Case of Kerion Celsi Caused by Trichophyton tonsurans / 대한피부과학회지

No Abstract Available.

A Case of Acute Urticaria after Minocycline Therapy for Acne / 대한피부과학회지

Minocycline is a semisynthetic tetracycline derivative that is widely prescribed systemic antibiotic for acne. But it is associated with a variety of adverse cutaneous reactions including fixed drug eruption, photosensitivity, hyperpigmentation, contact dermatitis, and generalized dermatitis of a morbilliform, urticarial, or exfoliative type. We herein report a case of acute urticaria in a 26-year-old woman who had taken minocycline for the treatment of acne.

The Preventive Effect of Systemic Treatment with Interferon-alpha2B for Infertility of Mumps Orchitis / 대한불임학회지

Postpubertal mumps may result in ochitis and permanent testicular atrophy may develop following infection. This present study was initiated to evaluate the preventive effect of interferon-alpha2B on infertilty after mumps orchitis. There were 21 patients with mumps orchitis between May 1990 and June 1997. Patients were randomly distributed into 2 groups: group 1 patients (n=13) maintained therapy with interferon-alpha2B (3x10(6) IU per day) and group 2 were managed by conservatively. All of the patients were evaluated with testis size measurement, mumps virus titer, hormone level, and if possible semen analysis. For group 1 patients symptoms disappeared within 2 to 3 days and the volume of testis returned to normal within 11 days and testis atrophy was not observed in all patients in follow up. But asthenospermia was continued in 4 patients (unilateral 2, bilateral 2). For group 2 patients symptoms disappeared within 5 to 6 days and the volume of testis returned to normal within 10 days and testis atrophy was observed in 3 patients (unilateral 2, bilateral 1) in floow up. Asthenospermia was continued in 4 patients (unilateral 2, bilateral 2). Sperm count and morphology were recovered all the recover in group 1, 4 patients had persistent reduced sperm count and morphology in group 2, respectively. These observations suggest that systemic interferon-alpha2B treatment is highly effective in preventing infertility as well as testicular atrophy after mumps orchitis.

A Case Of Spontaneous Ureteral Rupture / 대한비뇨기과학회지

We report a case of spontaneous uretreral rupture cured by conservative management. The patient(65-year-old man) who had left flank pain for 6 days was presented to our hospital. He had no history of trauma and previous urologic problems. Diagnosis was made by IVP and abdominal CT scan, which showed extravasation from left upper ureter and accumulation of a large amount of contrast media in the retroperitoneal space. On ureteroscopy, partial obstruction of left lower ureter was found and the upper ureteral mucosa showed diffuse erythematous changes. The rupture site with erythematous edema and some necrotic tissues was identified in lateral wall near ureteropelvic junction. A guide wire was passed upward the rupture site under direct vision of ureteroscope and then 6 Fr. double J stent was successfully palced. The stent was removed 4 weeks after the placement. Followup IVP showed good urinary drainange without evidence of extravasation.

An Idiopathic Infected Hydrocele in Neonate / 대한비뇨기과학회지

Acute scrotal swelling is unusual in neonates and it should be treated as an emergency, especially in case with a clear urine. Only a few cases of an infected hydrocele have been previously described in the neonateal period. We report a 29-days-old newborn who presented with acute scrotal swelling that proved to be an idiopathic infected hydrocele on surgical exploration.

Effect of Alpha Adrenergic Drug on Serotonin Release in Rat Hippocampal Slices / 대한비뇨기과학회지

PURPOSE: Peripheral adrenergic nervous system controls the penile erection and alpha adrenoceptors greatly outnumber beta adrenoceptors. It is known that adrenaline has a facilitatory effect but serotonin has an inhibitory effect on sexual drive centrally. But few about the effect of central alpha adrenergic drug to the release of serotonin centrally are known. Major adrenergic and serotoninergic innervation is found at the hippocampus. This study was performed to investigate the effect of alpha adrenergic drugs on serotonergic nervous system in rat hippocampal slices. MATERIALS AND METHODS: The hippocampus from the male rat brain was sliced. After 30 minutes` preincubation in the normal buffer, the slices were incubated for 20 minutes in a buffer containing 0.1 microM [3H]5-hydroxytryptamine(5-HT) for uptake, and washed. After administration of phenylephrine or clonidine, the release of [3H]5-HT into the buffer was measured and the radioactivities in each buffer and the tissue were counted and the results were expressed as a percentage of the total activity. The value of released [3H]5-HT was expressed as percent of the value at 50 minutes when a steady state of [3H]5-HT release was obtained. RESULTS: After administration of phenylephrine(10-5 M), clonidine(10-5 M), the values(mean+/-SE) were 133.4+/-7.3, 103.0+/-0.3 at 60 minutes and 128.8+/-4.6, 100.4+/-4.1(%) at 70 minutes compared to the values of control group, 96.6+/-1.9 % at 60 minutes and 89.6+/-2.3% at 70 minutes. The release of serotonin was increased significantly after administration of phenylephrine. CONCLUSIONS: It is suggested that alpha-1 adrenergic drugs may increase the release of serotonin and therefore the integration of these two neurotransmitters may be considered.